Being confronted with human suffering is not new to me. I still remember vividly the desperate wails of a mother in Yemen after we had transported her daughter's lifeless body back to her village. I can still see the woman dying of AIDS in Uganda lying on only a matt on the dirt floor of her hut with a sheet covering her wasted body that revealed the bony outline of each of her ribs. I will still wonder why the young couple in Papua New Guinea who lived their entire lives in poverty had to lose their only son to what started as a simple pneumonia that probably would have been easily treated in the U.S. I have shed tears and wrestled over questions of why... and at times I have seriously questioned whether I can reconcile my faith in the existence of a loving God in light of the seemingly indiscriminate suffering I have seen. I had thought that I had the question of suffering worked out in my mind and that nothing I would see on this sort stint in Mwanza would shake me. I was wrong.

Sayi, a 20 year old girl who came to Bugando the first week I was here, was severely wasted when she came in- I could easily wrap my thumb and index finger around her thighs and upper arms. Her eyes were sunken and bright yellow. Her abdomen was filled with so much fluid that it looked as though she were pregnant. Her liver was 2-3 times the normal size on exam and packed with hard nodules. She came with no records at first and she would not speak, but after some searching we found an old report of an ovarian cancer that had been removed about a year ago. It was obvious now that her cancer had spread to her liver and likely other organs of her body. Ultrasound confirmed diffuse lesions consistent with metastatic cancer. There was nothing we could do for her to treat her condition or even alleviate her discomfort except for drain the fluid from her belly now and then for her to breath more easily.

I had thought Sayi only spoke Swahili or her tribal language, but several days after she arrived she asked me, "What is your name?" It turns out she had been in school when she became sick and hoped to become a doctor. Her English was broken but she was remarkably proficient with a fairly broad vocabulary. She asked me several times if I could help her and I told her that we would try to keep her comfortable but that there was nothing that medicine could do to cure her. At this she turned her head away from me and said softly, "I am suffering."

About a week and a half after Sayi presented, an 11 year old boy named Matiku came in with a long history of shortness of breath and fatigue. He had signs of right heart failure with distended neck veins and a large liver. He was not making much urine. He had an extra heart sound on physical exam and so an ECHO was obtained (I was surprised to see that we had an ECHO machine and a talented echocardiographer to run it) which revealed a large tumor that was almost completely occluding his right atrium. I don't even know how he was still alive because only a trickle of blood was flowing around the mass and allowing his body to get blood and thus oxygen. There was talk of trying to take him to the OR. No heart bypass has ever been done here, though, and so his chances of dying in the OR were about 95%. There was a 100% chance he would die without the operation, however. In the end the surgeon did not want to try the procedure.

Just before I left for my journey someone gave me a book by Francis Macnutt entitled "Healing" that argues that God still can and does heal people through prayer. The author argues that somehow the Christian church has largely adopted a theology that God does not heal because there is somehow more redeeming value, spiritually, in suffering than in health. The result of this shift in theology from the early church's conviction that God regularly healed people through the prayers of the saints has resulted in Christians today no longer even asking for healing. Macnutt's arguments are convincing. Jesus himself pointed out in Matthew 7 that even more than a parent would for his or her child, God the Father desires to give good gifts to his beloved. In John 14 Jesus told the disciples that the miracles they saw Christ perform would not cease with his passing, but rather that "whoever believes in me will also do the works that I do, and greater works than these will he do..." In James 4 we are told that "we do not have because we do not ask".

I am confident that God CAN heal miraculously. I just don't know if He DOES any longer...at least commonly. But I must say that I WANT to believe that He does. Several days after Sayi came in I asked her if I could pray for her, and she said yes. I prayed that God would comfort her and put His hand upon her...but I did not ask that He would heal her. I think I was afraid of the implications on her faith...and on my faith...and on the faith of all of the people in the room looking on...if I asked for God to heal her and healing did not come. Several days later, however, I was completely overwhelmed on rounds by the fact that Sayi had no hope for any relief of her suffering...on this earth at least... apart from divine healing. After rounds I asked her if she would like me to pray for her again, to which she agreed, and this time I specifically asked for God to heal her.

Similarly, when I realized the bleakness of Matiku's future I felt compelled to ask his mother, this time through a translator, if she would like me to pray for him. She said yes. Through the nurse I told her that medicine and doctors were powerless to help her son, but that I believe God is always powerful. I told her that I would ask God to heal Matiku...but that God can choose how He will act. I said that all I know is that God loves Matiku even more than we do...and that Jesus said that those who trust in Him would live...even though they die.

For the few days following my prayers for each patient I went into the hospital hopeful...in fact even expectant...that I would see Matiku and Sayi up and energetic and breathing easily. The more days that passed with their condition unchanged the more I began to doubt. Today I went in to check in on both of them. Both of them died yesterday.

Some would argue that questioning one's faith is a sign of weak faith. Perhaps... but I think that questioning is vital to a healthy faith. I have had two major "crises of faith" in my life as a believer in Christ. The first came in college and the second in medical school and during those two several-month long stretches I questioned everything about what I believe and why. It was incredibly difficult at the time, each time, but I am grateful for having experienced those empty times. And now I have come to believe that it is good for me to occasionally go back and question and re-think what and why I believe.

I will admit that in the past few weeks I have had fleeting thoughts that perhaps everything I have based my faith upon is contrived. When I see indiscriminate suffering it is logical to entertain the possibilities that 1) there is no God, or 2) God exists but either does not care or does not have his hand actively involved in humanity. But I look around me and see His hand in creation itself. I can remember back to my time in anatomy lab and be reminded of how convicted I was that only a powerful and creative force bigger than life itself could have been responsible for what I was seeing. I have decided that I believe the scriptures are in fact God's word made known to man- and if that is the case I can be assured that there is no questioning God's love for humanity, as He spared nothing to redeem His people.

I do not know what I think about whether God still desires to...and in fact does... heal the way he did 2000 years ago. I know that he has our best interests at heart. I am certain that the tears those who suffer cry are seen and probably felt by their creator. I believe also that just as Jesus pleaded in the Garden that "this cup would pass," he cries to the Father at the side of those who suffer on earth now and asks for the same mercy. But I believe that the prayer is concluded the in the same manner that it was 2000 years ago- "but not my will be done, but your will be done." Certainly there is good in relief of suffering. But I have also seen that suffering can enable those once blinded to see that this world is hopelessly in need of a savior.

I have not seen God heal miraculously, but I know that He is alive and actively involved in my life and I am certain that he desires to have an active part in the lives of all who suffer (and all who don't suffer for that matter). I just don't know how that will play out, and of course I could not expect to know the intricacies of how God may choose to act. But I know that He has called me to serve and to love and in so doing be an extension of His hands. I know that He has charged me to ask for good gifts. I know that He has promised hope to those who have no hope and all I can do is trust that as a loving Father He has his children's best interests at heart... much more so than I do.